Pennsylvania Dental Ebook Continuing Education

__________________________ Caries-Prone Patients: Prevention, Assessment, and Interventions, 3rd Edition

The patient education pamphlet “Sip All Day, Get Decay!” produced by the Minnesota Dental Association (available at http://www.sipallday.org) states that the average 12-ounce can of soda has 10 teaspoons of sugar and a pH just over 3. The low pH of soft drinks results from the ingredient phosphoric acid. Sodas also contain carbonic acid, and many contain citric acid. Therefore, even diet sodas are detrimental to oral health due to their acidic pH levels. Patients who sip soda throughout the day cause their oral pH to plunge due to the acidity of the soda and the acid formed from oral bacteria metabolizing the sugars with this extended exposure a source of an increased risk for the development of dental caries [28]. Sports drinks and fruit juices also tend to be acidic and contain high amounts of sugar [29; 30]. The use of these products should be limited. Milk and water remain the best drink options for healthy teeth. The development of flavored, unsweetened water gives patients another drink option that is not detrimental to their teeth. FACTORS INFLUENCING DIET It is important for dental professionals to study the factors influencing patients’ diet choices to understand the motiva- tions behind them and to offer healthy alternatives. Factors influencing diet include food availability, family structure, con- venience, parental influence, habit, cost, and media [31; 32]. Food Availability and Convenience As the number of Americans who are eating meals prepared outside of the home continues to increase, food availability and convenience have become factors that greatly influence food choices. The majority of foods that are considered “convenient” are high in sugar, refined or fermentable carbohydrates, and fat [17; 18]. These foods are therefore unhealthy choices for oral and systemic health. Examples of convenience foods include hamburgers, chips, vending machine snacks, and candy bars. The prevalence of vending machines gives people access to many low-nutrient, energy-dense snacks on a daily basis [33; 34]. The Smart Snacks school nutrition standards became effective at the beginning of the 2014–2015 school year and established limits on the amount of fat, sugar, sodium, and calories in foods that are sold in vending machines within school settings [35]. The Smart Snacks school nutrition stan- dards have specific nutritional requirements for food items sold in vending machines, student stores, and snack bars [36]. However, simply not having these options available is not the complete answer. Hungry teens need to understand the ben- efits of high-nutrient snack options and learn to seek them out. Within the United States, vending machines are present in 43% of elementary schools, 74% of middle schools, and 98% of high schools [37]. Though Congress has mandated a reduc- tion of foods and snacks in schools that are correlated with

obesity and dental caries, schools continue to struggle with replacing these items with more nutritional, low-fat options as do hospitals and workplaces [38]. Many schools gain some rev- enue from vending machine sales, which adds to the complexity of changing food items. Schools, food vendors, and families continue to struggle with balancing nutrition, funding, and adolescents’ food preferences. Vending machines are found in many places besides schools, and the low nutritional quality of vending machine foods is generally consistent throughout the different locations [38]. Increasing the nutritional value of foods available through vending machines would have a positive impact on various groups. Dental professionals should educate patients about the healthiest and least caries-promot- ing vended items, such as sunflower seeds, nuts, crackers with cheese, and sugar-free gum. Many fast food chains have added more nutritious options to their menus in an effort to appeal to health-conscious consum- ers. Dental professionals can promote patients’ oral health by educating them about the impact of common convenience foods on the caries process and guiding them toward more healthful choices. Parental Influence Parental influence also plays a role in diet choices, especially those of children and adolescents [39]. Because parents gener- ally purchase the foods available for snacking and family meals, they have a high level of control over what foods are eaten by their children. Children tend to emulate their parents’ food choices [39; 40]. Parents’ food choices and nutritional guidance can be driven by habits, myths, misinformation, weight control efforts or problems, availability, and their own nutritional knowledge [17; 41]. Other factors that influence dietary choices include cultural preferences, parenting styles, and family dynamics [17]. Dental professionals should guide parents to not buy sodas and low-nutrient foods in an effort to discourage the formation of habits such as snacking and soda consumption that can contribute to caries. Parents may need to be guided to make healthy, affordable choices for themselves and their families. Also, parents can limit snacking by not allowing children to eat while watching television or playing video games. Educating parents about their influence and guiding them toward healthy food choices can benefit the entire family. Habit Eating habits start early and may be difficult to change, espe- cially as time solidifies these behaviors [39; 42]. Habits such as eating at the table, having a healthy breakfast, and eating fruits and vegetables can and should start in childhood; however, it is never too late to start these beneficial habits [40; 43]. Through discussing habits with patients, dental professionals can encourage behaviors that will promote oral health and identify caries-promoting practices that need to be altered.

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Book Code: DPA1525

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